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FCC Form 399: Reimbursement Request

Approved by OMB 3060-1178
Go to the Federal Communications Commission homepage at www.fcc.gov

(REFERENCE COPY - Not for submission) FCC Form 399: Reimbursement Request

Facility ID:
52425
Service:
DCA
Call Sign:
KSJF-CD
Channel:
19 (UHF)
File Number:
0000025228
FRN:
0021646880
Date Submitted:
06/20/2018

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

KTV MEDIA, LLC

Doing Business As: KTV MEDIA

Larry Morton

17200 Chenal Parkway

Suite 300 - 267

Little Rock, AR 72223

United States

+1 (501) 476-1507 EQUITYLEM@GMAIL.COM Limited Liability Company

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

Lindsey McGough

Lori E. Withrow, P.L.L.C.

Lindsey McGough

12410 Cantrell Rd.

Suite 100

LIttle Rock, AR 72223

United States

+1 (501) 227-2000 lmcgough@allenwithrow.com

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. No
Briefly describe transition plan This application is to convert Channel 50 to Channel 19. We will use the existing antenna and retune the transmitter and filter. The change that was assigned to us by the FCC resulted in a loss of population and coverage area. See attached explanation.

Transmitters

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Section Question Response
Transmitter Related Expenses Do you have transmitter related expenses? Yes

Primary Transmitter

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Existing Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model TRN-5X-4D-U-C
Year 2015
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity .50 kW

Primary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? No
Manufacturer
Model TRN-5X-4D-U-C
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity .5 kW
Justification for New Transmitter See KSJF-CD Project Description, items 2 and 3. It is cheaper to buy a used transmitter on frequency than to retune the existing transmitter.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring No
Size N/A
Length N/A
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

On-site engineering

It costs to set up the new transmitter and to hook it into the antenna system.

Antennas

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Section Question Response
Antenna Related Expenses Do you have antenna related expenses? Yes

Primary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Retune Existing
Antenna Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? Yes
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type Class Class A
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 1
Number of Panels 2
Design power capacity in use 50.0 %
Lower Limit 470.00 MHz
Upper Limit 690.00 MHz
Other Antenna Type N/A
ERP: 2.0 kW
Manufacturer Kathrein
Model KAT-723147 X1X2
Year 2015

Primary Antenna

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Adjustment to Existing Antenna

Section Question Response
Sweep Test of Existing Antenna Do you need a sweep test of existing antenna? Yes

Primary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna? No
Type
Number of channels supported N/A
Frequencies of channels supported N/A
Frequency

Primary Antenna

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Other Antenna Cost Not Listed

Information not provided.

Transmission Line

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Section Question Response
Transmission Line Related Expenses Do you have transmission line related expenses? No

Tower Equipment And Rigging Costs

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Section Question Response
Tower Equipment or Rigging Costs Changes Do you have tower equipment or rigging costs changes? No

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 50
Explanation To plan and oversee the transition from Channel 50 to Channel 19
Outside RF consulting Engineering Services Perform engineering study for new channel assignment and antenna development Yes
Prepare engineering section of Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority No
Quantity N/A
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority No
Quantity N/A
NEPA Section 106 environmental review No
Environmental Assessment No
ASR Modification No
FAA Consultation (including preparation of FAA Form 7460) No
Negotiation of Lease and other Matter for Shared Locations Yes
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers Yes
RF Field Engineering Services Comprehensive coverage verification via field study Yes
RF exposure measurements No
Additional Field Engineering Service Yes
Number of Days 2
Justification Confirm proper installation. (One day for 2 people)

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Tower Climber

Climber to check and test the antenna after channel change

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning Yes
Non-zoning permits No
BLM or NFS Coordination No
FCC Construction Permit Minor Change Yes
FCC License to Cover Application Yes
FCC Special Temporary Authority Application No
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? No
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? No
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

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Other Expenses Not Listed

Name Description

Construction Financing

Construction interest costs to build the project.

Sales Taxes

Not included in the item costs

Travel

Third party consultants travel reimbursement

Contingency

5% Contingency factor for unexpected items and cost increases over the course of the construction project.

Cost Information

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Transmitters

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $17,500.00 $17,500.00 N/A $14,787.50 N/A
Total for all systems $204,485.78 $104,510.78 N/A $36,322.50 N/A
Primary Transmitter TRN-5X-4D-U-C $17,500.00 $17,500.00 $14,787.50
On-site engineering $2,500.00 $2,500.00 We are requesting that this price be increased by $500 because the original proposal did not reflect the cost of installing a full service filter. N/A N/A
UHF - Air Cooled Solid State Transmitter .5 kW $15,000.00 $15,000.00 N/A $14,787.50 N/A

Components

Actual Information Description File Name
On-site engineering Information not provided.
UHF - Air Cooled Solid State Transmitter .5 kW

Component Description:
Per FCC instructions, the cost of the transmitter includes the Mask Filter. See the attached KSJF-CD Construction Permit requiring a full service mask filter. This amount was included in our estimate. We negotiated a discount off of list price.
Amount:
$2,520.00

Component Description:
Purchased and received the Transmitter
Amount:
$12,267.50

Cost Information

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Antennas

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $35,550.00 $5,000.00 N/A $0.00 N/A
Total for all systems $204,485.78 $104,510.78 N/A $36,322.50 N/A
Primary Antenna KAT-723147 X1X2 $35,550.00 $5,000.00 $0.00
Sweep test of existing antenna $6,730.00 $5,000.00 N/A N/A N/A
UHF - Lower Power Side Mount, Class A broadband panel (cost per panel) $2,520.00 $0.00 N/A N/A N/A
UHF - Lower Power Side Mount, Class A One Station antenna -- basic $26,300.00 $0.00 N/A N/A N/A

Components

Information not provided.

Cost Information

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Transmission Line

Information not provided.

Cost Information

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Tower Equipment and Rigging Costs

Information not provided.

Cost Information

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Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $125,290.00 $55,750.00 N/A $16,750.00 N/A
Total for all systems $204,485.78 $104,510.78 N/A $36,322.50 N/A
Outside Professional Services $125,290.00 $55,750.00 $16,750.00
Tower Climber $2,000.00 $2,000.00 Climber to realign the STL on the tower and to check and test the antenna after channel change. N/A N/A
Additional Field Engineering Service, 2 Days $2,000.00 $2,000.00 Confirm proper installation (1 day for two people) N/A N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $20,000.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $4,000.00 If required N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,000.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $4,250.00 N/A $4,250.00 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $3,000.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $7,000.00 N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A N/A N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A $2,500.00 N/A
Project management of the transition $7,900.00 $5,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Tower Climber Information not provided.
Additional Field Engineering Service, 2 Days Information not provided.
Comprehensive coverage verification via field study, if needed Information not provided.
Attorney Fees - Negotiation of lease and other matters for shared locations Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Payment of Legal fees for the Construction Permit
Amount:
$4,250.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Payment for preparation of the Engineering portion of Form 2100.
Amount:
$3,000.00

Component Description:
Payment for preparation of the Engineering portion of Form 2100.
Amount:
$3,000.00
Perform engineering study for new channel assignment and antenna development

Component Description:
Perform engineering study for new channel assignment and antenna development
Amount:
$7,000.00

Component Description:
Channel 24 Repack Study and antenna development.
Amount:
$7,000.00
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review reimbursement form

Component Description:
Preparation and review of the Form 399. Paid receipts were in previous submissions.
Amount:
$2,500.00
Project management of the transition Information not provided.

Cost Information

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Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $26,145.78 $26,260.78 N/A $4,785.00 N/A
Total for all systems $204,485.78 $104,510.78 N/A $36,322.50 N/A
Other Expenses $26,145.78 $26,260.78 $4,785.00
Contingency $2,877.45 $2,877.45 Allowance for items left out of the projections and cost increases during construction - 3%. See Contingency memo. N/A N/A
Travel $1,500.00 $1,500.00 Travel reimbursement for third party consultants travel. See Travel Memo. N/A N/A
Sales Taxes $2,340.00 $2,340.00 Estimate of sales taxes owed for equipment and services. See Sales Tax Memo. N/A N/A
Construction Financing $433.33 $433.33 Interest costs for financing the construction. See Construction Loan and Fees memo. N/A N/A
Local Zoning $2,000.00 $2,000.00 If required N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $4,785.00 Because we will have to file for a different channel to correct the interference our assigned channel receives we will be required to file Major Modification. See attached KSJF-CD Fee Waiver letter. $4,785.00 THERE WAS NO ESTIMATE FOR THIS BECAUSE WE WERE NOT EXPECTING TO HAVE TO FILE A MAJOR MODIFICATION BECAUSE OF EXISTING INTERFERENCE AND COVERAGE REDUCTION. See attached KSJF Robertson Letter-2 and KSJF 399 ADDITIONAL COST LETTER..
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 If required N/A N/A
Equipment Delivery and Handling Charges $1,000.00 $1,000.00 Shipping costs not included in individual items. N/A N/A
Develop and air announcement of upcoming channel change $1,000.00 $1,000.00 Payment to third-party to prepare the proper notification of the channel change. N/A N/A
MVPD Notification of Channel Change $2,000.00 $2,000.00 Cost to notify all MVPD providers of Channel Changes N/A N/A
DTV Medical Facility Notification $11,550.00 $8,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Contingency Information not provided.
Travel Information not provided.
Sales Taxes Information not provided.
Construction Financing Information not provided.
Local Zoning Information not provided.
FCC Filing Fees - Form 2100 minor change CP application

Component Description:
Because the Auction Taskforce gave us incorrect advice we had to file in the window that required us to pay a Major Mod fee. This was an unexpected expense we had to pay the FCC. See Attached Waiver Letter.
Amount:
$4,785.00
FCC Filing Fees - Form 2100 license to cover application Information not provided.
Equipment Delivery and Handling Charges Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
MVPD Notification of Channel Change Information not provided.
DTV Medical Facility Notification Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $204,485.78 $104,510.78 $36,322.50

Reimbursement Status

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Question Response
The facility has ceased operating on its pre-auction channel. No
Construction of final facilities or all necessary modifications are complete. No
All receipts for reimbursement have been submitted no further costs are expected to be incurred. Note this will lock the Form 399 from further editing and begin close-out procedures with the Fund Administrator. No

Certification

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Section Question Response
Submission of Estimated Expenses Statements

WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT.

  1. The Authorized Person signing below certifies that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity.

  2. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

  3. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.

  4. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (broadcasters) or to continue to carry the signal of a broadcaster that changes channels (MVPD).

  5. The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund.

  6. The above-named entity certifies that it will maintain and provide to the Commission detailed records, including receipts, of all costs eligible for reimbursement actually incurred.

  7. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.

  8. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.

I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

LARRY MORTON

Manager


06/20/2018

Attachments

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